Information Required for The Escrow Company Agreement

Is your company the Depositor or Beneficiary?

Registered company name:

Company registration number / ABN (if applicable):

Registered company address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your escrow agreement under Australian jurisdiction?

Software Product title:

The name of the product licensed to the Beneficiary

Would the Beneficiary like verification testing to be performed on the Deposit Materials?

Yes
No

What type of verification service would the Beneficiary wish to order?

Signatory contact name:

First

Last

Position title (ie CEO)

Signatory email address:

Signatory phone number incl country code:

Signatory contact name: 2nd Signatory

First

Last

Position title (ie Secretary) : 2nd Signatory

Signatory email address: 2nd Signatory

Business contact name:

First

Last

Position title (ie VP Operations)

Business email address:

Business phone number incl country code:

Depositor technical contact name:

First

Last

Position title (ie CTO)

Depositor technical mobile phone number incl country code:

This must be a mobile phone number that can receive SMS messages for MFA

Depositor technical email:

Would your company like access to The Escrow Company portal (Beta) - Depositor

Yes
No

Access to the portal will allow the user to view a copy of the signed agreement, file integrity test reports, verification reports, list of Git repos and the date of the last received deposit. Only the Depositor will be able to view the list of Git repos associated with the deposit materials.

Would your company like access to The Escrow Company portal (Beta) - Beneficiary

Yes
No

Access to the portal will allow the user to view a copy of the signed agreement, file integrity test reports, verification reports and the date of the last received deposit.

Is the person authorised to access The Escrow Company portal the same as the technical contact or someone else?

Same as technical contact
Someone else

Name of the user for The Escrow Company portal

First

Last

Position title of portal user (ie CTO)

Portal user mobile phone number incl country code:

This must be a mobile phone number that can receive SMS messages for MFA

Portal user email address:

List any other email addresses to receive reports issued under the agreement

Is your company responsible for the payment of invoices under this agreement?

Yes
No

Is your company registered in:

United Kingdom
European Union (EU)
Australia
Other (rest of world)

VAT number (UK and EU only):

Invoice processing contact came:

First

Last

Position title (Procurement Manager)

Invoice processing email address:

Invoice processing phone #:

PO number required on the invoice? If so, please provide it below. If unavailable, it can be added later.

Yes
No

PO Number (If available)

Depositor registered company name:

Beneficiary registered company name:

Information Required For Software Escrow Agreement